Nordoff Robbins - Music and Health Public Report

Mapping
Music and
Health
A Nordoff Robbins Consultation

(Abridged Version)
Josie Aston
Freelance arts and health consultant
March 2011
Mapping Music and Health: A Nordoff Robbins Consultation (Abridged version)
Copyright © Nordoff Robbins 2011 All Rights Reserved. No part of this document may be reproduced
without written consent from the Nordoff Robbins Research Department.
Creative Commons Attribution Non-Commercial No Derivatives 3.0 Unported
Nordoff Robbins Research Department

2 Lissenden Gardens, NW5 1PQ, London, United Kingdom
Tel: +44 (0)20 7267 4496

Email: research@nordoff-robbins.org.uk
Web: www.nordoff-robbins.org.uk
March 2011
Nordoff Robbins Research Department
www.nordoff-robbins.org.uk
Nordoff Robbins Music and Health Public Report 2011
Index of contents
Index of contents ............................................................................ 1
Foreword to Public Report.............................................................. 2
A Note from Josie Aston................................................................. 2
Background to the Report............................................................... 3
1. The context
1.1 Size and growth of the Arts & Health sector …………………….4
1.2 Economics, politics and public publicity …………………………5
1.3 Changes in healthcare; impact of the recession …………………6
1.4 Training for Music & Health ……………………………………..7
1.5 Evaluation and research ………………………………………..8
2. Practices in Music & Health: considering values and voices ...... 9
3. TEN MUSIC & HEALTH CASE STUDIES................................ 13
4. Training for Music & Health ........................................................ 7
5. Evaluation and research............................................................. 8
6. Conclusion................................................................................ 33
Appendix 1: Mapping of Music & Health projects ......................... 34
Appendix 2: People/organisations researched, by area ............... 36
Appendix 3: The Music & Health focus groups............................. 39
Appendix 4: Bibliography.............................................................. 44
1
Foreword to Abridged Report
That Nordoff Robbins should be excited about the Music & Health scene
comes as little surprise to those closely associated with its origins. From the
start of their pioneering work in the 1950s, Paul Nordoff and Clive Robbins
believed in music’s powerful role in accompanying young people through their
life journeys. What Nordoff and Robbins knew from their long collaborative
innovations, and what they have passed onto us all, is that music connects
people of all ages, ability and background. Music, they knew well, risks
shrinking when confined to ‘the therapy space’. Music, like us all, needs to
breathe, to be shared, to draw together people in all kinds of places and
times. Music needs to live!
This consultation – ably completed by Josie Aston and her colleagues -
affirms the passion that keeps music therapists and Music & Health
practitioners in their practices whatever the odds, in these cash-strapped
days.
Although the brief of the consultation was from Nordoff Robbins’ particular
position in this broad and complex field, the abridged version of the report will,
I hope, be useful to Music & Health practitioners, researchers and trainers
who believe in music.
Prof Mercédès Pavlicevic, Director of Research

London March 2011.
A Note from Josie Aston

I’d like to thank Niki Holmes, for assisting me with research, interviewing,
facilitating the focus groups and preparing case studies; Anna Barzotti, for
transcribing more than 40,000 words of focus group discussions and all the
Music & Health organisations and individuals that provided information,
agreed to be interviewed and attended the focus groups.
Finally, I’d like to express my gratitude to Nordoff Robbins and especially Prof.
Mercédès Pavlicevic for commissioning research into this important area. The
Music & Health sector appears to be at a key turning point, where it is on the
verge of achieving the sort of critical mass where it has to answer questions
about the extent to which it wishes – or can be – absorbed into the
mainstream of health and social care practice. This is, therefore, a very timely
piece of research.
Any views expressed in this report that are not directly attributed are my own.
Josie Aston1
1
Josie has managed a number of arts and health programmes in NHS hospitals, mental health trusts
and the community. She is the author of best practice guides for hospital arts co-ordinators on media
relations and the maintenance of artwork in hospitals.
www.josieaston.co.uk
2
Background to the Report

Nordoff Robbins (www.nordoff-robbins.org.uk) is the largest UK charity that
specialises in the transformative and communicative power of music. In
addition to its accredited training programme (Master of Music Therapy:
Music, Health, Society) and its dual entry doctoral programme in Music
Therapy / Music, Health, Society, Nordoff Robbins provides and supports a
range of specialist services that encompass the depth and breadth of music.
These include music therapy services, Music & Health projects, and
community music projects. Nordoff Robbins practitioners provide services in
arts, health, education and social care sectors, working with vulnerable people
from the cradle to the grave. The Research Department develops monitoring
and evaluation systems, undertakes research projects with practitioners and
supports service delivery by developing web-based resources (including The
Nordoff Robbins Evidence Bank; The Practitioner’s Guide to Evidence; The
Nordoff Robbins Research Ethics Guide (due 2011).
The brief for this consultation was to inform Nordoff Robbins about the Music
& Health (Arts & Health) arena in the UK, with the focus on Music & Health
Practices, Training and Research, thus reflecting Nordoff Robbins’ own
activities.
Since it quickly became apparent that the Music & Health sector is growing
even more rapidly than was thought, the research area was restricted to
England and Wales. Methods included desk research, interviewing key
individuals and organisations and three focus group discussions held in
London, Bristol and Manchester. In addition, the very varied practice and
scale of Music & Health initiatives are reflected in 10 case studies, to convey
the many ways in which Music & Health is developing in England and Wales.
This consultation has been very different from previous consultations,

because those contacted have been so glad to participate. People engaged in
Music & Health – even those in demanding senior positions – have been
extremely willing to make themselves available for interviews, to send
information and to attend focus groups. This shows the passion of Music &
Health practitioners for their work and their wish for it to develop more
strategically.
This report begins by setting the political, economic and organisational

contexts for the growth of Arts & Health sector (1) before considering Music &
Health practices from the perspectives of practitioners’ values and service
users’ voices (2). Case studies of 10 Music &Health organisations (3) report
on practices, training and evaluation/research, and the report concludes with
a brief commentary on training (4) and evaluation (5). The appendix lists
individuals and organisations who participated in this consultation, and a
bibliography.
3
The context:
1.1 Size and growth of the Arts & Health sector
From its beginnings in the 1970s, the UK arts and health2 sector has grown
exponentially. When I first interviewed for an arts and health job in 1999, I
could find only one publication to read to prepare for the interview. Today, I
would have a huge choice of relevant material.
The London Arts and Health Forum3 carried out a survey of arts and health in
the UK earlier in 2010, partly in order to generate content for the new national
arts and health website launched in August that year
(www.cultureandwellbeing.org.uk). The survey discovered 600 organisations
and 800 individuals working in arts and health in the UK; many of these
individuals and organisations are working with music in a variety of ways.
The Music & Health Centre at the Royal Northern College of Music has more
than 600 email addresses on its mailing list. There are at least 100 arts co-
ordinators in English and Welsh hospitals; many of the arts programmes they
run include music in some form4. Meanwhile, increasing academic interest in
the area of work is demonstrated by the launch of two specialist journals in
the last eighteen months – Arts & Health and Applied Arts and Health.
Music education programmes run by professional arts organisations once
worked mainly with schools and families but now reach out to many other
groups including mental health service users, looked-after children, refugees,
prisoners and care home residents. Specialist organisations such as Live
Music Now and Youth Music have developed expertise in training musicians
to work in these new settings and have formed partnerships with health and
social care providers.
Britain’s energetic amateur and voluntary music sector is also increasingly
engaging with arts for health. In Wales, the Healthy Sounds programme
founded in 2007, has enabled hundreds of volunteer musicians to perform in
healthcare settings (see Case Study 3, ‘Healthy Sounds’), while earlier this
year, Voluntary Arts England produced a guide to arts and health for its
members5. Making Music, the organisation that represents 2,900 voluntary
and amateur music groups throughout the UK has also recently taken an
interest in arts and health, forming a partnership with the British Lung
Foundation’s ‘Breathe Easy’ groups to encourage people with chronic lung
disease to sing.6
2
As in the brief for this project, ‘arts and health’ and ‘music for health’ are used at times
interchangeably and at times in parallel in this document.
3
See www.lahf.org.uk.
4
There are no central data on this. This figure is estimated from the invitation list for a national
seminar for hospital arts co-ordinators I organised with Arts Council England in 2006. Research
published by the London Arts and Health forum in 2007, commissioned by Arts Council England,
stated that of London’s 32 acute trusts, 19 responded to a questionnaire about their arts
programme, and of these, 13 had held music performances in the last year.
5
Devlin, Paul, ‘Restoring the Balance: the effect of arts participation on wellbeing and health’,
2010. Available as a free download from http://www.voluntaryarts.org/uploaded/map13606.pdf.
6
See http://www.lunguk.org/supporting-you/breathe-easy/aboutbreatheeasy and
http://www.makingmusic.org.uk – London Harmony newsletter.
4
1.2 Economics, politics and public policy
Arts and health, as described above, is a burgeoning sector. However, in

England7, there has been an ongoing issue with achieving official recognition
for arts and health, both in terms of policy and in the way in which health and
social care services are organised and funded.
It has certainly not helped that arts and health practice touches on aspects of
the portfolios of the Department for Business, Innovation and Skills, the
Department for Communities and Local Government, the Department for
Culture Media and Sport, the Department for Education, the Department of
Health, the Department for Work and Pensions and the Ministry of Justice!
Arts Council England did significant work to develop arts and health in the
1990s and the 2000s. This included commissioning an academic, Dr Rosalia
Staricoff, to carry out a search of medical literature published between 1990
and 2004 that explores the relationship of the arts and humanities with
healthcare, and the influence and effects of the arts on health8. The Arts
Council supported a number of arts and health posts and projects through
money awarded from Grants for the Arts and the National Lottery9; it was also
successful to some extent in levering support for the sector from non-arts
sources such as the Department of Health.
In 2006 the Department of Health and the Department of Culture, Media and
Sport issued a Joint Prospectus on Arts and Health which included the
statement:
“the arts are, and should be clearly recognised as, integral to health and
health services”10
It is interesting to reflect on whether it is generally necessary to publish a 200

page full colour document arguing the case for something that is already
‘recognised as integral’. Be that as it may, the Prospectus represented an
official acknowledgement of the existence of the sector from both the health
and arts bureaucracies.
7
In Wales and Scotland, arts and health has been somewhat more prominent in terms of
policy, due in part to the emphasis given to culture by the devolved governments and the fact
that these governments fund the arts directly, unlike in England where the Arts Council has
maintained the ‘arm’s-length’ principle of arts funding. That there are very serious health
challenges in both Wales and Scotland may also be relevant.
8
Arts Council England, ‘Arts in health: a review of the medical literature’, 2004. Free
download from: http://www.artscouncil.org.uk/publication_archive/arts-in-health-a-review-of-
the-medical-literature.
9
The situation with the National Lottery and Arts Council funds is complicated, as the Arts
Council originally wished to make a clear distinction between grants made from Exchequer
funds and those made from Lottery monies; however, in practice the Arts Council set the
policy for both and a number of arts and health projects have received grants from both
sources.
10
Arts Council England, ‘A Prospectus for Arts and Health’, 2007, p5. Available as a free
download from http://www.artscouncil.org.uk/publication_archive/a-prospectus-for-arts-and-
health/.
5
However, the same year that the Prospectus was published, the National
Network for Arts and Health took the decision to close. Arts Council England
dropped arts for health as a key part of its portfolio at the end of the 2007-8
financial year, ending the arts for health posts that it had, at that time, in each
of its regional offices. The Arts Council continued to accept applications for
arts and health projects to its Grants for the Arts programme and the National
Lottery has remained a major funder of the sector.
Arts for health as a whole in the UK is now represented nationally only by the
London Arts and Health Forum (LAHF), which is staffed part-time by one
person. In fact LAHF’s role as national advocate for the sector is unofficial: it
serves this function by default because there is no other organisation to call
on, and because many national organisations are based in London. This is a
striking contrast with the position in America, where the Society for the Arts in
Healthcare, founded in 1991 (nine years before the now defunct British
national network) has over 1,700 members and acts as an effective advocate
for the development of the field there11.
1.3 Changes in healthcare; impact of the recession
By the time the Coalition government took power in 2010, therefore, arts and
health was a burgeoning sector, but one that was lacking in national
leadership and direction. Arts and health was not well integrated into public
policy and was not seen as a key part of the portfolio of any particular
government department or QUANGO (quasi-autonomous non-governmental
organization) – not even that of Arts Council England, previously its key
champion.
However, healthcare policy appears to be changing. The White Paper issued

by the Coalition in July this year, Equity and Excellence: Liberating the NHS
has set out a radical programme of change to the NHS to take place between
2010 and 2013, including the abolition of strategic health authorities and
Primary Care Trusts and the transfer of their functions to local authorities and
GP consortia respectively; the creation of a new National Commissioning
Board accountable for NHS funds; and a major cut to the Department of
Health’s budget.12
Current figures suggest that the GP consortia will have around £80bn to
spend on patient treatments and prescriptions13. If even a fraction of that were
spent on Music & Health services, whether through direct funding of projects,
personal budgets or ‘Arts on Prescription/Referral’-type schemes, it could be a
very significant boost for the sector. There is also the possibility of funding
Music & Health work through the public health budgets that will be transferred
to local authorities (around 4% of the current NHS budget e.g. £4bn).
11
See www.thesah.org.
12
Available as a free download from:
www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH
_117353
13
http://news.bbc.co.uk/1/hi/programmes/newsnight/8940884.stm.
6
As I write the final words of this report, the Coalition government’s

Comprehensive Spending Review is about to be published, and it seems
extremely likely that as a result there will be substantial cuts to many of the
public sector budgets which have previously supported arts and health
activity. This is on top of the reduction in funds now at the disposal of grant-
making trusts and foundations due to the global downturn.
However, I believe that there are opportunities as well as threats in such a

situation, and that with good planning and a creative approach, arts for health
may be able to capitalise on some of the changes. Some of our focus group
participants were, in fact, feeling quite optimistic about their organisations’
prospects in a situation where health and social services are faced with major
cuts:
“The trust are going to have to make big cuts…so [we should] put other
offers on the table for them, for the same outcomes you know…I am
hoping that now that they are financially strapped they might actually be
forced to…think creatively.”14
In summary, the situation at the moment is changing so quickly that it’s hard
to use past developments to predict the future of Music & Health. However, if
Music & Health organisations manage to survive the current round of budget
cuts, the sector may be able to take advantage of the more creative
approaches to health and well-being that could emerge. After all, the Arts
Council itself grew out of the Committee for Encouragement of Music and the
Arts, founded in 1940, a time when Britain was not only at war but had no
NHS and little social care. People need music more than ever in difficult
times, and as one of our focus group participants remarked: “We are doing
the Big Society thing already!”15
1.4 Training for Music & Health
The emergence of specific training courses in Music & Health is a relatively

recent phenomenon and there is as yet no standard practice or agreement on
what core competences for a musician in health might be. Skills are learnt as
much on the job as in the classroom, and supervision or mentoring from more
experienced practitioners is a key feature of many training programmes.
Three types of training were identified: community music-style modules
offered as part of music degree courses; introduction to therapy courses
offered by Nordoff Robbins and other organisations; and a range of training
available to musicians outside higher education environments.
The range of skills needed and challenges faced by musicians wishing to

work in healthcare setting are considerable; and appropriate training of health
14
Focus group participant, London.
15
Focus group participant, Manchester.
7
and social care staff is recognised as equal in importance to the training of

musicians.
1.5 Evaluation and research

The topic of evaluation and research is one that is of considerable interest to
the arts and health world, yet at the same time, it creates anxiety.
Evaluation in the arts is often confused with advocacy, and this is as true of
arts and health as of the mainstream arts sector. Part of the problem is that
the majority of arts and health practitioners are from arts rather than health
backgrounds and therefore have little grounding in research, in the sense that
health funders conceive it. Therefore, much ‘research’ in the arts turns out on
close inspection to actually be evaluation, or in many cases, a mixture of
evaluation and advocacy. One cannot do effective research on the impacts, if
any, of an arts and health activity if the decision has already been made that
the outcomes will be positive. This is not a new problem. As pointed out in a
report by the Institute of Public Policy Research, published in 2004.
It must be said that the impact of arts participation on health is notoriously

hard to prove, as the effects are largely intangible ones to do with identity,
feelings, skills and social inclusion. Partly because of this difficulty, and also
as a result of restrictions on funding and time available to complete projects,
there is a fair amount of reluctance in the sector to evaluate at all.
However, the standard of evaluation is improving and robust research in arts

and health is beginning to emerge. The ultimate aim would be to develop an
approach to evaluation that is sufficiently rigorous to be credible, while also
respecting the subjective elements of a creative musical experience. It is vital
that practitioners are convinced that evaluation and research will be of
assistance in developing their practice, rather than just a ‘box-ticking’
exercise.
8
2. Practices in Music & Health: considering values and

voices
It is noticeable that two aspects of arts and health work: the values underlying
it, and the voice of the individual service user, don’t always come through
explicitly in the literature. To avoid this report being yet another example, I
have included a brief discussion of the values behind arts and health work,
and the role and needs of the service user, before embarking on a more
detailed consideration of practice, training and research in the sector.
What are our values?
John Browne is a freelance composer for opera and music theatre. A few
years ago he went to Rwanda to make a music theatre piece there with
survivors of the genocide. One outcome of that experience was that he
applied for, and got, a post as Composer in Residence at the Florence
Nightingale School of Nursing and Midwifery at King’s.
He is now coming to the end of the year-long residency, and he told our
London focus group how it has caused him to reflect at the most basic level
on the values he brings to his work, because every time he approaches a
group of nurses with an idea, the initial response is invariably anxiety and “I
can’t sing.” He explained, “we need a whole shift in the culture, a big shift,
that everyone owns music, it is not an elite trained group…it is innate, it is
universal, it is part of everyone and everyone has a right…”16
John went on to say that although nursing developed as a vocation and has
historically been strongly allied to certain religious and spiritual beliefs
concerning the need to care for others, his experiences at King’s have made
him feel it has become a case of:
“professionalise, professionalise, science, science, measure, measure,

economics, form, form, dah, dah, dah and so there is now a shift in
consciousness which is saying actually compassion is a radical new
idea! We must introduce empathy…and then measure it!”17
Sarah Derbyshire, Executive Director of Live Music Now reflected the feelings
of the group when she commented that work such as John’s was going to
make a big difference to relationships with healthcare professionals, because:
“…the minute you involve them [professionals] with an activity you are
delivering to the people that they are caring for, that convinces them.
You don’t really need to do very much more than that to convince them
because they begin to see how it’s making them feel…”
16
London focus group, John Browne.
17
Ibid
9
Where are service users in all this? What do they want?
Music & Health organisations vary enormously in their relationship with their
service users/patients/customers/participants/clients/learners. This can be
seen in the case studies included in this report and indeed, is demonstrated in
the variety of words used to describe the participants.
How an organisation describes its participants is often a clue to the model

used: whether that is top down, where the Music & Health project is designed
by the external music organisation with some input from health/care staff; or
bottom up, where demand for service users leads to the commissioning of a
service.
There are of course, good rationales for both types of model. Organisations
such as Live Music Now (see Case Study 4) and Music in Hospitals work on a
national scale, and employ many hundreds of musicians. The groups they
make music with include young offenders in secure institutions and frail
elderly people with dementia. It would not be practical to design such projects
on a service-user led basis, or to fundraise the kinds of sums needed to
underwrite the activity (more than £1m annually in the case of Music in
Hospitals). Besides, Music in Hospitals’ ethos is to provide music for
entertainment and positive distraction, rather than to enable the sort of in-
depth individual participation that other types of Music & Health projects aim
to deliver.18
Core Arts (see Case Study 10) works in a very different way and has
successfully engaged with communities that other organisations struggle to
reach, such as African-Caribbean people with severe and enduring mental
health problems. As Paul Monks, the organisation’s director explained in our
London focus group:
“[We were] always about delivering what people wanted. We now have
something like 300 members of the community a year…The focus is
not on therapy but on meaningful endeavour, so we train people in
skills and also [the] opportunity to perform and have about 70 events a
year…80% of our trustees are actually past or current service users.”19
However, it is the case that service user-led groups may struggle to get
sufficient resources to make an arts activity sustainable, no matter how much
they may want and benefit from it. An example of a music project set up by a
woman living with MS was recently featured in an Evening Standard
campaign – although fortunately this was in the context of the group having
received a grant that has saved it from closure, at least until the end of the
financial year.20
18
Interview with Diana Greenman, Director, Music in Hospitals, 17th June 2010.
19
London focus group.
20
http://www.thisislondon.co.uk/standard/article-23886460-our-dispossessed-fund-helps-
brave-caroline-to-keep-the-music-working-its-magic.do.
10
There are also a number of examples of Music & Health organisations that
work with young people, which have gone to great lengths to empower their
participants to acquire and develop skills in different styles of music. This is an
area of provision that did not exist when I was a young musician myself, when
youth music was almost entirely focused on classical music.
In some cases this activity has the potential to open up career paths for the
young people that they might not otherwise have considered. For example,
Youth Music’s Music Leader programme has enabled many young musicians
to access training in leading music activities, while organisations Youth Music
supports such as the Youth Music Action Zones (see Case Study 1,
‘Changing Tracks’) are increasingly looking to create personal and career
development pathways for their participants.
It is possible that the changes occurring in healthcare could work to help

service users to commission music activity directly. In our Manchester focus
group, Andrew Hudson from Seed Studios reflected on the beneficial impact
on his organisation of personalisation, where mental health service users are
given individual budgets to purchase their own care. Seed Studios is part of
BlueSCI, a wellbeing service in the Trafford area; service users can make and
record music there.
“…moving the commissioning to the GPs has been really positive for
us…all the members who attend our service are going back to their
GPs and [saying] we have been going to this music service…the GPs
understand us whereas [with] the PCTs it was harder to say look what
we are doing [because we had to] dress it up in a language that they
would understand.”21
Andrew went on to explain that through some types of commissioning:
“…you get service users together to ask for a service…that group of

people [is] enabled and empowered to then form a group…and apply
for funding themselves…So they have a budget and they can buy a
laptop, or alternatively pay a cello teacher or someone to come and
play a concert, you know, anything that is going to help them keep
well…”22
Good Music & Health initiatives tend to be flexible enough to allow people to
move along the spectrum from passive listening to active engagement, as
trust is gradually built up between musicians and the participants. Nick Cutts,
another focus group member, described how his group of musicians had
given a performance on an elderly rehabilitation ward in Derby (mentioned in
Case Study 9):
“…it was only by stopping playing that we were able to find out about
the musicians in the group and a lady that was in her 90s that had
21
Manchester focus group, Andrew Hudson.
22
Ibid
11
been a concert pianist around the world then became the leader of the
session, which was incredibly empowering for her…”23
This prompted Kathryn MacDonald from More Music in Morecambe to tell us

about an older people’s group, The Seagull Café, that her organisation had
set up in partnership with a number of agencies:
“…we now run the session regularly as there are so many older people
who have not done anything for years who are singers, trumpet
players, pianists and it has became…[a] forum for their self expression
and not about them just listening to our musicians.”24
Given the UK’s rapidly ageing population - nearly 20% of the UK population is
now over retirement age, which means for the first time in recorded history,
there are more pensioners in the UK than there are under-16s25 – the
likelihood is that there will be increasing demand from older people for the
type of engagement described by Kathryn above.
While there are of course older people in challenging financial circumstances,

it is also worth bearing in mind that older people own 80% of the private
wealth of the UK, with over-65 year olds controlling £460 billion in
unmortgaged equity alone.26
When Dartington, the arts and social justice organisation based in Devon,
consulted on its mooted flagship retirement community, in which creativity and
personal development will run alongside support for life, it was deluged with
enquiries.27 Perhaps as the population ages we will hear much more about
what the service user wants, and needs, to live a healthy life.
23
Ibid
24
Ibid
25
Audiences London resource pack for ‘Bolder and Wiser: Older People and Culture’, held
October 2009. Available as a free download from:
http://www.audienceslondon.org/1286/symposia/bolder-and-wiser-older-people-and-
culture.html.
26
Ibid
27
See http://www.dartington.org/abundant-life.
12
3. TEN MUSIC & HEALTH CASE STUDIES

CASE STUDY ONE: National organisation
The HIVE: Youth Music Action Zone Regional project
Changing Tracks
www.hiveonline.org.uk
Changing Tracks is a project that aims to use music to encourage young

people to make positive life choices.
Changing Tracks sessions, with kind permission of the Youth Music Action Zone
The Hive is an independent arts organisation based in Shrewsbury that works

across Shropshire, Telford & Wrekin to give young people opportunities to
learn, have fun and be creative, through music and media.
The Changing Tracks project began in 2006 as part of a community policing

initiative to engage local youths in a series of DJ-ing workshops aimed at
breaking down barriers between the youths and the police. As well as
generating rapport between the two groups, the project hoped to encourage
young people to report crime, as there was strong evidence that crime against
14-25 year olds was being under-reported, especially on two local estates.
The first of the Changing Tracks sessions was attended by a large number of
drunk and disorderly young people and resulted in damage to equipment and
the venue. There were three arrests and this aspect of the community police
outreach was then abandoned. Although this experience was extremely
challenging for those involved, it did highlight the need for outreach and
engagement work with young people about their alcohol abuse and its social
and health consequences. Shropshire as a county has a very high rate of
underage alcohol abuse.
From the ashes of the initial project, the ‘Changing Tracks’ project was
developed by a steering group of interested bodies in 2007. These included:
the North Shropshire Young People’s substance misuse team (County
Council); Shropshire Drug and Alcohol Action Team (PCT); Community
Regeneration (Town Council); Shropshire Youth Connexions (Department of
Education) and the Shropshire Youth Association, with Shropshire &
Herefordshire Youth Music.
13
The team were successful in winning a bid for substantial funding from Comic
Relief for a proposed programme of music sessions and workshops.
The project was planned as a three year pilot programme, aiming to engage
young people that are abusing alcohol, or at risk of doing so. The focus of the
project was to provide a new format for working effectively with participants to
enable musicians, and alcohol misuse workers, to support individuals to face
up to their drinking and its likely consequences in their life, and to make better
life choices.
The life choices agenda is not overtly pushed and there is no ‘preaching’.
Instead, session workers provide a forum for frank and confidential
discussion. This trust is founded on mutual respect and interest grown
through music. Participants are enabled to use their music as a platform for
exploring/sharing problems and issues in their lives that lead them to drink.
Frequently, the drinking is symptomatic of complex personal and social
problems, such as bullying, neglect, domestic violence, sexual abuse,
poverty, poor educational achievement and mental health problems.
The project facilitates a maximum of three groups at any one time. Each
project runs for 8 to 10 weeks. The numbers of participants varies. Sessions
can accommodate up to 15, however, generally each group has a core of 5-6
individuals that attend all or most sessions and a further dozen or more that
drift in and out.
Each weekly session has a different music skill or styling emphasis, to keep
interest high. The project manger and principal music leader Sven Worrow
commented that it takes 2-3 sessions for the participants to feel confident and
comfortable, and to begin to feel open to discussing the Alcohol Action aspect
of the project. Each session is facilitated by one of a team of 4 workshop
leaders including Sven, with a further 2-4 musicians/technicians shadowing
activity and enabling participants to learn music skills.
Sven Worrow is an experienced musician who has worked extensively with

young people and is a qualified counsellor. His skills and capabilities have
been key to the project’s success so far. However, Sven acknowledges that
he would benefit from further professional development. He feels that finding
accessible quality training and supervised work experience is a hurdle for
musicians interested in this kind of cross-sector working.
The Youth Music team has experienced difficulty finding musicians with the
necessary skills and experience and in sourcing suitable training. They also
wish to encourage young people from their project to acquire music
leadership skills to make the project sustainable, provide training, work
experience and potentially formal accreditation.
Changing Tracks are in discussions with their current major funder Comic
Relief for a further three years of funding. They are now developing a new
project with the local Mental Health Trust and community mental health team
for young people following their first diagnosed crisis.
14
CASE STUDY 2: The Music Well Local organisation

Community Drumming Circles
and Singing Groups
www.themusicwell.org.uk
The Music Well is a community interest company providing music

therapy sessions and musical activities such as drumming circles and
singing groups for the promotion of health and wellbeing in the local
community.
Music Well sessions, with kind permission of Liz Butt
The Music Well was set up by Liz Butt. A registered music therapist, she has
been running a music therapy service in Rye, East Sussex, since 2004. Liz
believes that the community itself is a ‘well’ of musical resources and that by
coming together to share musical activities, the health of each individual as
well as that of the community can benefit.
Liz Butt trained at Roehampton as a music therapist nearly 25 years ago and
has set up Music Therapy services in several schools and, more recently, in
her own home in Rye, East Sussex. She has a large collection of instruments
gathered over the years from all over the world. This collection forms the
basis of Music Well’s instrument resources for facilitating therapeutic and
group musical sessions.
Liz has bases at the Rye Community Primary School, and at her own home
where she sees adult clients. The Music Therapy service at the school is
intended for any child from the area with needs that could be addressed
through music. Liz’s clients come to her though a variety of referral routes,
including self-referral, referral by parent/guardian, the local education service,
the local children’s centre, services for cared for children and referrals from
other care professionals.
As an individual therapist, Liz does not attract any statutory body’s funding or
support. Many of her clients pay her directly for their therapy. Liz wishes to be
able to offer her services based on the client’s need rather than their ability to
pay and therefore also takes on non-fee paying clients. She has been
successful in gaining grants from Jessie’s Fund, the Otakar Kraus Music Trust
and Rye Town Council to cover the cost of this work.
15
At the time of writing, Liz had 15 individual clients and about the same number
again involved through sessions at the school, including a drumming circle
session with children that also attend individual sessions.
Liz realised that in order to grow and develop community music therapy in
Rye, she and like-minded individuals that share her belief that all sorts of
music can be beneficial and that the health of the community itself can be
enhanced, would need to set up a formal organisation. In July 2010 Music
Well was formally constituted as a Community Interest Company. This has
already enabled Music Well to expand from its base in individual music
therapy to include other musical activities for health and wellbeing, and will
ensure that Music Well can continue to run, expand and fundraise.
Liz currently has funding bids being considered by the Sussex Community
Foundation, the Rye Fund and Tesco Community Fund, that will enable Music
Well to start new projects with older people with memory and coordination
problems and people affected by anxiety and depression. This development
should see Liz and her colleagues running sessions not just in the local
school and Liz’s own home, but also facilitating music activities and therapy
visits to the housebound and many more groups within the community.
Drumming Circles
Liz and her colleague specialise in facilitating drumming circles. The circles
are open to anyone to play hand drums and percussion. Each group is an
end in itself rather than for performance.
The size of the drum circles varies from 4-15 people. Those who have
joined the drum circles have given reported benefits including: being part of
a group; feeling empowered and self-confident; an increased physical
wellbeing; being given a chance to share emotional expression in a safe
and non-confrontational way; laughing and having fun; better rhythm and
physical co-ordination; and overcoming communication boundaries and
difficulties through rhythm.
Groups Music Well’s music leaders have facilitated have included: an

educational group for children; a support group for disabled people; a
social get-together for older people; a group for people with mental health
needs such as depression; staff team bonding, group music therapy and a
group for community cohesion.
Singing Groups
In recent months, Music Well has added Singing Groups as another strand
to its community music offer. In its promotional material Music Well refers
to research on the impact of singing on health and provides a link to videos
about the benefits of singing to mental health on the NHS Choices website.
16
CASE STUDY 3: National organisation

Ty Cerdd / Healthy Sounds!
www.tycerdd.org/healthysounds
A Wales-wide initiative to enable and encourage amateur music groups

to build links with healthcare providers and the wider community
through performance.
Ty Cerdd, the Welsh Federation of Amateur Musicians was formed in 1969

and serves nearly 400 amateur music-making societies throughout Wales.
Each of the 400 members pays a small annual fee for access to Ty Cerdd’s
network, representation/advocacy and information on grants and
opportunities.
In 2007, Keith Griffin, Director of Ty Cerdd – Music Centre Wales contacted

Edwina Hart, Welsh Assembly Government Health Minister, to enquire about
meeting to explore ways in which they could highlight the ‘good health’
advantages of performing in community based music groups. The initial idea
was to celebrate the continuing popularity of this activity amongst the older
generation.
Following a meeting with the Minister, the Director sent a questionnaire to

member societies to gauge their interest in participating in a scheme which
would provide music in publicly funded healthcare settings. The response was
encouraging, and in March 2008 the Welsh Assembly Government
announced the “Healthy Sounds!” partnership between the Government and
Ty Cerdd - Music Centre Wales. In promoting this scheme, the Government
wished to acknowledge the contribution that amateur music makes to life in
the local community, and the benefits to general health and well-being that
come from participation in music activity. Ty Cerdd administers the project
and to date has received £50,000 a year since December 2007 to run the
programme.
The purpose of the project is to enable and encourage amateur music groups
to build links with healthcare providers and the wider community through
performance. The scheme involves performances by amateur music societies
and school ensembles, at hospitals and other centres where there is nursing
care provided by the NHS. The Healthy Sounds! project has been promoted
through own Ty Cerdd’s membership network, but non-member organisations
and individual musicians are also eligible to apply.
It is the responsibility of the performing ensemble to negotiate the time and

place of performance with the chosen healthcare centre, and to provide Ty
Cerdd with these details. Ty Cerdd take no role in creating relationships
between music groups and NHS settings, nor do they offer guidance with
regard to the type of group, the form and quality of musicianship or repertoire
appropriate to the healthcare environments in which the musicians arrange to
perform.
17
In some hospital settings, an arts co-ordinator has been available to make

arrangements. In others this role has been undertaken by the Widening
Participation and Communications office or by health service or care
managers. No training or advice on performing in a healthcare environment
has been provided to the groups through the scheme directly, although some
groups have requested advice and signposting to training or mentoring via the
Ty Cerdd membership services.
Once the proposal has been approved in principle by Ty Cerdd, a claim form
is sent to the society for completion and return after the performance has
taken place. The scheme provides societies with a means of raising useful
additional income and also of strengthening their ties with, and profile within
their local communities. Through the Healthy Sounds! scheme, amateur
music groups may apply for small grants, of up to £200 per performance for
groups of more than 6 musicians and £100 for small groups. Some of the
music groups already had links with healthcare settings and the receipt of a
‘Healthy Sounds!’ grant has therefore been of assistance in acknowledging
the value of the musician volunteers to enhancing patient experience.
A very varied mix of musicians, choirs, brass bands, blues bands and Live
Music Now graduates have received grants to perform in settings such as
hospital concourses, wards and care homes for the elderly. In the first year
686 performers received grants and 14,010 people attended performances.
The presence of people from the wider community in the healthcare setting
helps to maintain the setting’s connection to that community’s cultural life.
This is of particular importance with regard to the performance of Welsh
language choral singing as Welsh is the first language of significant numbers
of older people in hospital in North Wales.
No formal evaluation of the project is currently undertaken by Ty Cerdd,

although they ask for brief comments from the host healthcare centre on the
claim forms. It is not known if the music groups, or the healthcare settings
hosting them undertook their own more rigorous evaluation or reflection on
these performances.
Quarterly meetings between Ty Cerdd and The Welsh Assemble office for
health are also held to monitor the scheme’s progress. The longevity of the
project seems to rely entirely on a personal understanding between the
Director of Ty Cerdd and the Welsh Minister for Health that live music – any
live music, whether it is performed by professionals or amateurs – is a good
thing in a healthcare setting.
The simplicity of the scheme has meant that it has not placed any excessive
administrative burden on the host organisations or the music groups. This
has made the scheme particularly attractive, as it requires minimal effort on
top of other duties for the large number of residential or day-care units that
have been able to offer their staff and patients/residents access to live music
and a couple of hours’ diversion through ‘Healthy Sounds!’.
18
CASE STUDY 4: Live Music NOW National organisation

Meaningful Moments
www.livemusicnow.org
Live Music Now (LMN) is the largest provider of live music to the UK's
welfare, educational, justice and health sectors, with a unique resource
of specially trained musicians.
LMN project images, by kind permission of LMN
It is now 33 years since LMN was founded by Yehudi Menuhin and Ian
Stoutzker. In that time it has grown to nine branches covering the whole of the
UK and Northern Ireland, with some cross-border initiatives in the Republic of
Ireland.
Although LMN is a national organisation, each regional office has a great deal
of autonomy to form partnerships, develop projects and funding bids. In order
to avoid duplication, branches are encouraged to develop pilot projects that
can be rolled out to other areas if successful.
Over the years, LMN’s model has evolved from one-off concert provision to
providing half day or full day workshops and regular visits. LMN's music
programmes, comprising over 3,000 workshops and performances, are given
each year to some 200,000 people. Settings include: schools for children with
special needs; centres for adults with physical and mental health problems;
hospices; homes for older people including those living with dementia; and the
justice system.
LMN uses music in the promotion of Active Engagement - supporting social

cohesion, teamwork and participation; Life Skills - developing confidence,
communication, transferable skills; Health and Wellbeing - effecting positive
improvements in mental and physical health and Professional Development -
training musicians and staff in the delivery of music outreach.
The organisation employs over 350 musicians. Musicians typically join LMN
post-college, at the age of 23 or 24, and stay into their 30s. LMN has recently
increased its investment in the recruitment, auditioning and training of
musicians to enable uniform opportunity and access across the UK. Most
music conservatoires have LMN alumni on their staff. LMN’s musicians have
gone on to careers in music therapy in some cases, as well as in counselling
and other types of therapy. One even retrained as a doctor.
19
Joining LMN means young musicians can use their skills as ‘connectors’,
promoting health self-expression and open communication. LMN is careful to
make a clear distinction between musicians and music therapists. LMN insists
that musicians are empowered and respected by the host organisation’s
professional health and care staff.
When LMN was founded music outreach was still unusual. Now the
organisation wishes to maintain high quality and standards of practice in its
own projects and as leaders in the sector, as well as share knowledge with
other organisations in what has become a rapidly expanding field.
Meaningful Moments
LMN has been successful in developing and maintaining partnerships with

other organisations, in fields aligned to all areas of its work. Partners in work
with older people include Order of St John Care Homes, the Department of
Health’s Dignity in Care Campaign and National Dementia Strategy and
funders for this work include the Bank of America Foundation, Balance
Foundation, Dulverton Trust City Bridge Trust, the Rayne Foundation and the
European Commission’s Lifelong Learning Programme.
LMN musicians and staff in care settings have created self-contained projects
which are specifically designed to meet the needs of elderly participants. This
has been of particular benefit to LMN’s work with older people living with
dementia, for whom almost 40% of their work with older people is delivered. A
specific strand focusing on dementia was developed, resulting in a pilot
project at Nightingale House in 2006, in which two musicians ran monthly
sessions for a specific group of dementia patients.
Meaningful Moments was the resulting two-year programme, designed to

have a positive impact on older people, and the policy care standards and
practice in the sector. This was done through enhancing the physical,
emotional, mental and social well-being of over 2,000 elderly residents and
staff in 76 care homes run by the Order of St John in Wiltshire, Oxfordshire,
Gloucestershire and Lincolnshire. The programme included over 300 musical
events and aimed to challenge ageist attitudes and prejudice, as well as to
encourage the participation of residents’ families and other visitors.
In 2009 LMN commissioned Platform 3 to carry out an external evaluation of

Meaningful Moments. The key findings of this evaluation were that the project
had improved the well being of older people, particularly those with severe
dementia; that the most effective events were those where care staff were
actively involved in the social aspects of the events; and that LMN should
offer focused training of musicians, working in this sector, perhaps involving
external accreditation.
LMN has not carried out a great deal of research, but is keen to build the
evidence base for the benefits of the work they do. As an organisation they
have expressed difficulty finding the right partner to enable them to design
and undertake quality research.
20
CASE STUDY 5: Regional

Sing for your Life – Silver Song Clubs organisation
http://www.singforyourlife.org.uk
"We choose things to sing for people that have an emotional resonance,
that allow them to express their emotions such as feeling cross or sad
as well as happy.” Chreanne Montgomery-Smith
Sing for your Life project images, by kind permission of Chreanne Montgomery-Smith
In 2005, Chreanne Montgomery-Smith, the co-founder of the Alzheimer’s

Society’s ‘Singing for the Brain programme’ and her team began working in
collaboration with Making Music South and the Sidney de Haan Centre for
Arts in Health, to develop a framework for expanding the programme. This
led to forming of the independent not-for-profit company and registered charity
‘Sing for your Life’, established in 2005 to improve quality of life, health and
wellbeing for older people through participation in musical activities.
‘Sing for your Life’ have gone on to receive a special commendation from the
Royal Society for Public Health and are the UK’s EU health PROelderly
project nomination. They are part of the Big Lottery Fund Chances4Change
programme and have held the 'V' award for volunteering excellence.
Sing for your Life as an organisation has been successful in forming many
links and alliances to enable them to develop, deliver and fund the work that
they do with older people in care and the community. Their statutory partners
include strategic health authorities, primary care trusts, social care and
partnership trusts, county, borough and district councils, and adult services.
Third sector partners include Dementia UK (the provider of Admiral Nurses),

Age Concern, Help the Aged and The Alzheimer’s Society. Their music
delivery partners include Live Music Now, Making Music, Music Mind Spirit
and Chances4Change.
The Silver Song Clubs
Sing for your Life’s core activity is running the Silver Song Clubs, regular
sessions of social and community music making for older people.
21
There are now over 40 Silver Song Clubs meeting across the South East of
England. Over 1,500 older people attend a Silver Song Club each month and
this number is set to reach 2,000 by the end of 2010. Silver Song Clubs take
place in a variety of venues including community venues, day care centres
and hospital settings.
Many of the older people who attend Silver Song Clubs have a variety of
health issues including stroke recovery, COPD, Parkinson’s disease and
dementia. The Clubs are funded through partnerships with local PCT and
adult services.
The Silver Song Club model is based on a strong evidence-based

methodology that has been formulated through a research partnership with
the Sidney de Haan Centre for Arts and Health. Each session is delivered by
trained facilitators and supported by volunteers.
The trainers are all professional practising musicians from performance or

education backgrounds. They undertake a programme of training in the Sing
for your Life method, which follows through stages of observation of an
experienced trainer, assisting sessions, leading sessions under supervision
and then ongoing mentoring and oversight.
Trainers undertake continued observation of their group against specific

outcomes that are part of ongoing research. These include social interaction,
reminiscence, mental and physical exercise and coordination, breath control,
challenge, empowerment and coping with challenge.
Active participation is crucial to Silver Song Clubs’ success. Everyone is

encouraged to join in with a range of musical activities including not only
singing but also playing percussion, using hand chimes and gentle chair
based exercises. A typical session will last 90 minutes and is divided into two
sections with a refreshment break in the middle. A variety of songs will be
used and activities will include action songs, hand chimes, percussion and
gentle chair based exercises.
Stuart Brown, Director of Sing for your Life, is at present engaged in planning
a new initiative that the charity is currently developing, a Singing for COPD
programme (currently untitled). Participating patients will be referred by their
GP to the acute hospital for assessment, whereby on diagnosis of COPD,
they will be referred on to the Pulmonary Rehabilitation Team who will offer
the singing programme as part of their rehabilitation treatment.
Subject to final approvals (and the effects of the Spending Review) this
programme may go live this year.
Sing for your Life will also be expanding and adapting their services to attract
the BME community.
22
CASE STUDY 6: Michaelhouse Chorale Local organisation

Community Choir
www.artsandminds.org.uk/projects/2008/michaelhouse.html
The Michaelhouse Chorale is a community choir attended by 12-20

members each week. The members are mental health service users,
their informal or professional carers, and friends.
Michaelhouse Chorale, Cambridge, by kind permission of the participants
The Michaelhouse Centre is a registered charity situated in St Michael’s

Church, Cambridge city centre. It opened in 2002 and offers an affordable
meeting space, rooms for hire and a popular café.
In 2007, the Centre sought advice regarding ways in which they might offer
friendship and support to people with a mental health problem. There is
mounting evidence that singing offers a number of benefits for those with a
mental illness.28 The suggestion offered to Michaelhouse was that, in
collaboration with the local arts and mental health charity ’Arts and Minds’
(Cambridgeshire Foundation for the Arts & Mental Health), they might
consider hosting a choir for mental health service users, their informal and
professional carers, and their friends. This proposal was welcomed.
An Awards for All grant of £4,000 was obtained to pay for a professional
music director, music and administration. Michaelhouse made no charge for
the use of the church as a venue. The young director of music at the nearby
University Church of Great St Mary’s, was appointed to run the choir. As he
had no experience in mental illness, he was given an induction and initial
training. Fliers advertising the choir were widely circulated throughout the
local mental health trust, to GPs and mental health groups, and the
‘Michaelhouse Chorale’ started to meet weekly on 9th November 2007.
Anybody with a mental health condition is welcome to drop in to the choir,

whatever their age or illness, together with informal and professional carers
and friends. The purpose of the choir is enjoyment in a friendly, relaxed
community setting, and no previous experience is required.
28
For instance, the research by the De Haan Arts & Health Research Centre at Canterbury
Christchurch University, by Stephen Clift and his colleagues.
23
The repertoire reflects the taste of the members and covers a wide range,
from classical and church music to folk and songs from the shows. Sessions
start with physical and vocal exercises to aid relaxation, and an element of
movement and drama is encouraged in some of the pieces. Members can
offer a contribution of £1 to £2 a session, and most do so, but it is not a
requirement.
An internal evaluation was carried out in May 2009, when the Chorale had
been running for 18 months. It consisted of face-to-face conversations with
people of different ages with different diagnoses who had been attending the
choir regularly, together with some written comments, comments from carers
and also notes made in the music director’s weekly diary.
The number of people attending the Chorale each week varies between 12
and 20. A core group of participants attend weekly and express real
disappointment if there is a break (e.g. for a public holiday). Others tend to
drop in irregularly, according to the state of their illness. The age range
includes mental health service users in their 20s and 30s, but the regular
members are mostly middle-aged or older people who find it easier to give a
commitment.
Illness covers anxiety, panic attacks, mild and serious clinical depression,
schizophrenia, bipolar disorder and dementia. A number of carers and
friends attend regularly. Some participants have sung before, or play(ed) an
instrument, and can read music, one being an established composer. Others
have never sung, or not since school, and are unable to read music.
Key benefits for mental health service users:
• Engagement and participation in a meaningful activity in the city centre

• The learning of a new skill, or a return to an activity previously enjoyed
• An increase in self-worth, and an opportunity to be in control of what
they do
• The boosting of self-confidence, and a contribution to well-being which
helps in coping with their mental illness; a reported reduction in
medication
• Social inclusion, mutual support, friendship and respect for others
• Opportunities for meeting people, making friends, relaxation and
enjoyment
Key benefits for carers:
• Social contact with other carers and the making of new friends
• Respite and relaxation
• An opportunity to share and enjoy an activity with the person they care
for
One choir member, aged 70, has gone on to take and pass a music theory
examination, and another, a young man with schizophrenia, has started a
music degree.
24
CASE STUDY 7: First Taste Local organisation

3Ms, TOPIC and PACT
http://www.firsttastecharity.co.uk
A charity in Matlock, Derbyshire providing activity including music for

older people in care settings, and training for care staff.
TOPIC project images by kind permission of First Taste
First Taste was started 13 years ago, by a group of people in Matlock whose
parents were living in care homes. The First Taste founders were
underwhelmed by what was on offer to the residents by way of entertainment
and stimulation. They sought a direct and practical way in which to improve
older people’s experiences, though offering workshops in arts and crafts, led
by volunteers.
In time the voluntary group was able to demonstrate marked improvement in

the general well-being of their clients. Confident of the support of a number of
local care homes and day centres, the group succeeded in obtaining funding
from the local Community Education Council. At this time the charity
coordinated a vibrant mix of classes and workshops, driven by demand from
older people in a dozen residential homes in the area. Subjects included lip-
reading, pottery, needlecraft and music.
With the closure of the Community Education Council in the 1990s the charity
fell on hard times and had to withdraw from a number of settings due to lack
of money. In 1996 the charity successfully bid for an Awards for All grant of
£5,000, to continue and expand their music offer; this became the basis of
further funding bids for music-based projects.
In recent times First Taste has experienced the beginnings of a growing

market in providing such services to care homes. The number of
organisations, franchise businesses and individual musicians offering services
to lead music workshops and arts activities is increasing. This has lead to a
number of homes in which First Taste was active, contracting in other service
providers. First Taste has unwillingly become part of a Dutch auction29, and
has therefore had to reduce its session fees to retain clients.
29
An auction where service contracts are awarded to the lowest bidder.
25
Elderly care settings pay £20 for a First Taste tutor to facilitate a session, with
the rest of the cost of providing the service being subsidised/absorbed by the
charity. However, First Taste is still undercut by businesses offering sessions
of ‘movement and singing to special CDs’. Many of the care home managers
do not see any additional value to their residents from access to the kind of
live music and participation workshops offered by First Taste.
3Ms, TOPIC and PACT
First Taste currently run a music-based project called 3Ms (Melody, Memory
& Movement), funded by the National Lottery, and an interactive arts
programme in day centres for older people, supported by Derbyshire County
Council’s Older People’s Services. The 3Ms project was the recipient of a
NIACE30 award for quality care in end of life and one individual ‘learner’, as
First Taste refer to their participants, won a ‘Adult Learner of the Year’ prize.
The facilitated sessions continued under the brand TOPIC: ‘Tutoring older
people in care’. This two year programme ended in 2009. Fourteen
residential homes and one day centre took part, engaging 1,200 residents.
106 Certificates of Achievement were awarded to care assistants to reward
their involvement.
At this stage First Taste commissioned an evaluation of TOPIC by an

independent arts coordinator, Helen Fraser. A major finding of the evaluation
was the need for greater support of the teachers and for protocols for
engagement with host settings, to safeguard the tutors and the learners. All
too frequently tutors reported being ‘abandoned’ by care staff who wanted to
undertake paperwork and other tasks, leaving the tutors to ‘care’ for residents.
Another recommendation of the evaluation was the need to engage care staff
themselves with education and the arts. This led to a current First Taste
initiative called PACT (Participation Arts Carers Training) which will run for
three years and is funded by Sainsbury’s Headley Trust, UK Online, the
Ernest Bailey Trust, the Esmée Fairbairn Foundation and Arts Council
England, East Midlands.
The PACT programme includes an element of ‘training’ for care staff to

observe TOPIC sessions and then go on to leading their own music centred
activity sessions. At the end of the course the care staff will be awarded a
certificate of completion. This is not an accreditation of any kind since the
project has no academic partner.
It is disappointing to reflect that many of the key recommendations of the

independent evaluation undertaken by Helen Fraser, regarding tutor training,
self-reflective practice, professional boundaries and supervision, have not
been implemented. First Taste, and its participants, would greatly benefit from
external guidance and oversight of their projects, especially from an external
evaluation partner.
30
National Institute for Adult Continuing Education.
26
CASE STUDY 8: Oldham Music Service Local organisation
Bronchial Boogie/Drumming Down Dyspraxia
http://www.oldham.gov.uk/community/music-
service.htm
Using music to address health conditions in children and young people.

Oldham Council Music Service is committed to supporting and fulfilling the
musical aspirations of all young people living in the borough and engaging
people of all ages in a variety of exciting musical activities. The Music Service
was rated 'Outstanding' in a recent Federation of Music Services evaluation.
For many years the Service has been engaged in the development and
delivery of numerous projects that aimed to boost their participants’ well-being
and signpost them to better life chances. The Service has also instigated
projects that worked with healthcare professionals using music as a
‘therapeutic’ tool to achieve better health for children and young people.
These projects were pushed forward largely thanks to the vision and
determination of the Music Service’s Wendy Andrew, who is about to start her
retirement. The two projects outlined here are Bronchial Boogie – wind
instrument lessons for breath control, alongside use of medication training
provided by special community nurses, for children with asthma, and
Drumming Down Dyspraxia – drumming and movement workshops to develop
better coordination, assessed and monitored by healthcare professionals.
Bronchial Boogie
Images by kind permission of Oldham Music Service
Oldham is the 38th most deprived local authority out of 354 authorities in
England. Standard Mortality Ratio for respiratory disease is 36% higher in
Oldham than the UK overall. Hospital admission rates for asthmatic children
living in deprived wards are higher in comparison with more affluent wards.
The wards targeted for this project showed above average hospital admission
rates for children with asthma. These children are forced to take significant
time off school because of their illness.
Bronchial Boogie is an innovative project for asthmatic children devised as a
partnership between Oldham Music Service and Oldham PCT.
27
Bronchial Boogie provides asthma education, breathing exercises and wind

instrument tuition and brings children together for mutual support. The project
offered a new approach, using the teaching of wind and brass instruments
(flute, clarinet and cornet) to deliver health education to children and to
monitor their general and respiratory specific health. There are currently six
primary schools and one children’s centre involved. During the sessions a
trained asthma nurse and instrumental teachers work with small groups of
children.
The project started in 2002, funded with an initial grant from the National
Lottery; further funding was received from The Children’s Fund and in 2007 a
three year HM Treasury, Communities for Health award followed.
The Bronchial Boogie project has achieved national acclaim and the results
have been encouraging. The children involved have experienced improved
respiratory health, fewer sleepless nights, better school attendance, greater
self esteem and increased ability to join in sporting activities. Celebratory
concerts have demonstrated their achievements to a wide audience.
Drumming Down Dyspraxia
Images by kind permission of Oldham Music Service
In 2006, the Drumming Down Dyspraxia pilot project explored ways in which
percussion work and movement to music might help children with Dyspraxia.
Dyspraxia, also know as Development Co-ordination Disorder (DCD) is a
motor learning disability where the information needed to perform movement
is often not processed or fully understood by the brain.
Oldham Music Service percussion staff and a Dalcroze Eurhythmics specialist
teacher developed a series of workshops which took place every week over
an 18-month period. Although only a pilot project the results were promising.
The workshops involved the children learning to play various percussion
instruments. The activity was not presented as music therapy to the
participants; rather the children experienced learning percussion instruments
through different styles of music, with improvements to their motor and co-
ordination skills emerging as a side-effect of their enjoyment.
The project was funded by Arts Council England and involved the Music
Service in partnership with the Physiotherapy Unit at the Royal Oldham
Hospital, FDK (Fantastic Dyspraxic Kids) parental support group, and a
paediatric occupational therapist.
28
CASE STUDY 9: ‘The Grove’ music participation Hospital-based

project; AIR in partnership with OPUS arts project
http://airarts.net/
Music in the AIR Arts Programme, Derby Hospitals NHS Foundation

Trust: encouraging participation in hospital inpatient settings
OPUS/Grove sessions by kind permission of OPUS and AIR
Arts to Aid Wellbeing: AIR is a relatively new hospital arts programme, led by
arts coordinator Juliet Cooper, founded in 2007 to promote and deliver the
arts within the Derby Hospitals NHS Foundation Trust. Funding has come
from a two year Grants for the Art award from Arts Council England, the
National Lottery and through support from Derby Hospitals NHS Foundation
Trust, the Derby Hospitals Charity and Derby Healthcare plc.
With an annual footfall of 1.5 million people and an attractive new and
refurbished building, the Royal Derby Hospital has established itself as a
superb venue for music. The AIR music performance strand has included
string quartets, harp recitals, performances by local choirs and African
drumming.
Alongside scheduled performances in public areas of the hospital, AIR has

coordinated the delivery of music participation and performances in ward and
treatment settings related to cancer, rehabilitation and care of the elderly.
Following the success of the music in ward projects, AIR and its partners are
currently developing proposals to provide opportunities for patients in other
areas of the Trust.
Partnership with OPUS
One of the proposed outcomes for the music section of the AIR programme
was to develop and facilitate relationships between the hospital trust, its
departments, and performers. The purpose of this was to enable longer term
(residency) research projects to be developed with research topics to be
developed jointly by artists and clinical staff.
A number of pilot projects were undertaken to enable the trust to work with
new artists/artists groups (OPUS being one of these) and to explore which
departments would find this type of activity most beneficial and which staff
would be keen to get involved in the planning of future projects.
29
Following this pilot work, AIR has identified suitable areas for work to be
developed further and some key staff members and a number of partner
artists with whom this work is to be developed.
As a result of one of the pilot projects, The Grove (Elderly Rehabilitation

service) was identified as having a clear need for a music activity, and also a
location in which a longer term project would be effective. OPUS was then
approached as a suitable partner for this residency.
OPUS offers creative music-making opportunities which not only engender a

passion for music-making, but a desire for creative learning. OPUS works in
partnership with other organisations and agencies across the East Midlands
and beyond to ensure a coordinated approach to creative music delivery. All
musicians within OPUS are highly experienced professional performers,
composers and workshop leaders.
The project undertaken by the OPUS at The Grove elderly rehabilitation

wards involved musicians giving six weekly half-day sessions. The purpose of
the sessions was to deliver a musical performance over lunchtime in the
wards followed by an interactive workshop between musicians and the elderly
ward community.
The overall aim of the project identified by ward staff was to encourage
patients to eat lunch together in the main communal area. It was hoped that
the music events would give a focal point for social interaction among
members of the ward community, thus alleviating boredom and depression. It
was felt that patients were not making use of the communal area and that
subsequent low interaction among patients was resulting in instances of
isolation.
By offering this musical interlude, individuals could be encouraged to interact

with musicians and fellow patients. According to OPUS’ monitoring, over the
six sessions an average of 14 patients participated. They were assisted in
their participation by seven staff on average each session.
At the end of this successful project, The Grove and OPUS both expressed a
strong interest for the work to continue. OPUS wishes to maintain and grow a
larger-scale programme of ongoing work in partnership with Derby Hospital
and AIR is currently looking at ways to make this work financially sustainable.
OPUS are about to begin two other residencies in hospitals in the region.
Their musicians will be taking music-making into the Derbyshire Children's
Hospital in Derby and Sheffield Teaching Hospitals until December 2011.
OPUS is committed to increasing capacity for music-making in hospitals and
is therefore providing training for musicians alongside these residencies in
partnership with musique et santé (Paris) and MusicLeader.
30
CASE STUDY 10: Core Arts London-wide organisation
www.corearts.co.uk
A thriving community of musicians and artists with severe and enduring

mental health issues.
Core Arts was created in 1992 by the artist Paul Monks who set up his studio
in a vacant ward in the old Hackney Hospital. His workspace became a haven
for artistic expression by curious patients, seeking refuge from the monotony
of life on the psychiatric wards. Core Arts gained charitable status in 1994 and
since then Core has expanded to become a thriving community of artists,
musicians, performers and writers, serving service users with severe and
enduring mental health issues, across the London area.
Core now occupies the St Barnabas building in Hackney and in 2006

launched a capital campaign to purchase it. Core has been successful in
attracting funding and support from numerous organisations to facilitate its
work. These include the City & Hackney Mental Health Trust, the City and
Hackney PCT, the London Borough of Hackney, Arts Council England, the
Esmée Fairbairn Charitable Trust, the Lloyds-TSB Foundation, Merrill Lynch
Europe PLC, New Philanthropy Capital, the Tudor Trust, the Wates
Foundation and many more.
Core Arts has an empathy with the experiences of psychiatric patients and
nurtures artistic talent, looking at the person as an artist not a patient.
Through recordings, paintings, videos and poems the lives of the members
are enhanced. Each individual’s skills are highlighted, strengths developed
and their confidence raised by becoming an artist, poet or musician who is
contributing fully to society.
To become a member of Core Arts, individuals must have had at least one
recent hospital admission and be in current contact with mental health
Services or have a Care Plan Approach supported by a care professional. All
members are offered additional counselling support alongside the work they
do with the arts tutors. Tutors and volunteers have this support too and can
flag up issues with members when necessary. The counsellors keep in
contact with care team staff and feed back on member activity, providing the
member has given consent.
Individuals can refer themselves to Core Arts or be referred via their

supporting mental health team. People from the London Borough of Hackney
31
are fully funded by local mental health services. Those from other London
Boroughs also often have their fees paid in this way. In addition, Core accepts
referrals from those using direct payment schemes with their supporting
mental health team. A free taster day is provided to prospective members so
that they can try out a variety of sessions and workshops before deciding
whether to join.
Core’s premises house a recording studio with separate control room, a

rehearsal studio, a midi (digital music) studio, a computer training area, a
large hall and performance space, two art studios, four offices, a garden, and
a reception and meeting area. The external events programme includes 40
gigs and exhibitions a year, seen by over 20,000 audience members. Core
has over 50 creative educational workshops available to its members.
Music
Since 2007, Core’s music workshops are held in a fully equipped digital
recording studio offering Logic 7, Reason 3 and Ableton Live software. Core
has upgraded its events space with stage lighting and a sound system,
enabling members to enjoy a high quality performance stage within their own
building, and has introduced urban production workshops delivered by tutors
and volunteers with industry knowledge.
Core offers workshops tutored by professional musicians as well as by highly

skilled volunteers drawn from many different musical and cultural
backgrounds. The workshops cater for members of all standards, from those
just starting out learning a new instrument or skill to experienced musicians.
Performance skills workshops covering a range of various aspects such as

aural awareness, positive practice and preparation are taught and are very
popular classes. Online music has also grown. Core Music has a strong
presence on MySpace; some members have had as many as 56,000 plays
and downloads. Core has also established a link with www.TuneTribe.com
to enable the digital download of recorded work.
Recently, Core Arts members have performed at festival events such as

Stoke Fest and Bonkers Fest and at events promoted in partnership with the
London Symphony Orchestra’s Discovery Programme. Through Core
Promotions, members have played at local venues such as Barden’s Boudoir,
the Hackney Empire, Biddle Bros and Chats Palace.
The creation of associated social enterprises and social firms has been
actively encouraged by Core Arts, in order to provide members with a bridge
to the outside world. Several of the enterprises launched from Core are in the
music sector. Core sets time limits on ‘incubating’ these projects before they
must act as fully autonomous businesses.
32
6. Conclusion
This survey of the ‘territory’ of Music & Health in England and Wales suggests
an enormous amount of activity ranging from small to large scale. It is clear
that this activity varies in quality. The arts and health sector as a whole is
disparate and lacks national representation and advocacy. Despite valiant
efforts on the part of individuals and organisations, the sector has not so far
succeeded in making a united case for support, either to the arts bureaucracy
or to health. This may change; however, in the meantime, it would be possible
to make a strong, well-reasoned case for the benefits of music, specifically, to
the health and wellbeing of individuals and communities. The evidence is
growing, and can be built on.
It was apparent from the conversations that took place during this project that
many Music & Health organisations and practitioners hold Nordoff Robbins in
high regard. While they do not always know exactly what it is that music
therapists do, they are aware that quality Music & Health practice requires
attention to the safety of both participants and the musicians, well thought-out
training, mentoring and supervision, strong relationships with health and
social care staff and an approach to evaluation that is sufficiently rigorous to
be credible, while also respecting the subjective elements of a creative
musical experience.
33
Appendix 1: Mapping of Music & Health projects

Entire consultancy project*
* The red map pins indicate Music & Health organisations which were mapped
in this project, rather than being a comprehensive map of Music & Health
activity as a whole.
34
Music & Health projects mapped – Greater London area*
Music & Health projects mapped – Midlands area*
* The red map pins indicate Music & Health organisations which were mapped
in this project, rather than being a comprehensive map of Music & Health
activity as a whole.
35
Appendix 2: People/organisations researched, by area

East of England
• Aldeburgh Music
• Professor Jenny Secker, Anglia Ruskin University,
Cambridge/Chelmsford
• Arts & Minds Cambridge/Michaelhouse Chorale
• Britten Sinfonia
• Lifecraft
• Music for Health Research Centre
• Norfolk Arts & Health Partnership
• Sing Your Heart Out
• SoundSense
London
• Core Arts
• Guy's and St Thomas' Charity
• Florence Nightingale School of Nursing, King’s
• Hillingdon Mind
• Hospital Arts, Chelsea and Westminster Hospital
• Irene Taylor Trust ‘Music for Prisons’
• Islington Music Forum Ltd
• Ladder to the Moon
• London Arts & Health Forum
• LSO Discovery
• Royal Academy of Music
• Royal Brompton and Harefield Hospitals’ arts programme
• Royal Philharmonic Orchestra
• Music for Life (Wigmore Hall)
• Vital Arts, Royal London Hospitals
National
• British Association of Art Therapists

• Barchester Care Homes
• Dalcroze Society
• Drake Music
• Headway
• Live Music Now! (also eight regional branches).
• London Arts and Health Forum
• Making Music (national organisation for amateur music)
• Music in Hospitals
• Music Leader National Team
• National Association of Music Educators
• Youth Music
36
North East & Yorkshire
• Centre for the Humanities, Health and Medicine at the University of

Durham
• Live Music Now, North East branch
• Lost Chord
• Music for Health, Shipley
• Sage Gateshead
• University of Sunderland
North West
• Arts for Health, Manchester Metropolitan, University

• Arts for Recovery in the Community, Stockport
• BlueSCI (arts and social inclusion), including Seed Studios
• LIME Arts, Manchester
• Live Music Now, North West branch
• More Music, Morecambe
• Oldham Council Music Service
• Royal Northern College of Music
• Sense of Sound, Liverpool
• Start in Manchester - Arts and Mental Health Project
• Trafford Council Music Service
• Wear Purple, Oldham (Age Concern project)
East Midlands
• AIR, Royal Derby Hospitals

• Arthur & Martha (community music project)
• Big Difference Company
• Derbyshire Arts Partnership
• East Midlands Strategic Health Authority
• First Taste (music for older people)
• Healthy Arts - Derbyshire County Primary Care Trust
• High Peak Community Arts
• Northampton University
• Nottingham City Council Music Service
• Nottingham County Council
• OPUS Music
West Midlands
• Arts into Health, Walsall

• Arts for Health programme, South Staffordshire & Shropshire Health
Care Foundation Trust
• Birmingham Children’s Hospital
• Birmingham City University (MA in Art, Health and Wellbeing)
• Creative Communities Unit, Staffordshire University
37
• The Creativity Team, Solihull (arts and health consultants/evaluators)

• Hedz, Birmingham (urban music and art for youth)
• Shropshire Music Service
• Sound Futures, Birmingham Youth Music Action Zone
• Sound It Out Community Music, Birmingham
• Telford Council Arts in Health
• Telford and Wrekin Music Service
• Youth Music Action Zone, Shrewsbury
South East
• Professor Stephen Clift, Sidney de Haan Centre, Folkestone,

University of Canterbury Christchurch
• Professor Paul Camic, University of Canterbury Christchurch
• Dr Rod Paton, Lifemusic, University of Chichester
• Glyndebourne Festival Opera (education department)
• Music for All
• Music, Mind and Spirit Trust
• Neil Springham, British Association of Art Therapists/Oxleas NHS
Foundation Trust (Harmony Choir)
• Singing for the Brain/Alzheimer’s Society
• Sing for your Life/Silver Song Clubs
• Trish Vella-Burrows, Sidney de Haan Centre, as above
South West
• Arts and Health South West Network

• Avon & Wiltshire Mental Health Partnership NHS Trust
• Bournemouth Symphony Orchestra
• Bristol Children’s Hospital
• Bristol City Council
• Bristol MusicSpace
• Rachel Millman, Head of Music Therapy, Nordoff Robbins South West
• Tri-Arts, Royal Cornwall Hospitals NHS Trust
• Norma Daykin, University of West of England
• Willis Newson Ltd, Bristol (arts and health consultancy)
Wales
• Bangor University School of Music

• Joanna Briggs Institute, Cardiff University
• Community Music Wales
• Live Music Now, Wales
• Pengwern College, Rhyl
• Royal Welsh College of Music & Drama
• Touch Trust
• Ty Cerrd - Sounds Healthy, Cardiff
• University of Wales, Newport
38
Appendix 3: The Music & Health focus groups

In order to maximise everybody’s time, Josie and Niki organised focus groups
during late September and early October 2010, for invited guests from Music
& Health organisations in the London, Bristol and Manchester areas. We
chose regions that we knew from our previous research had a critical mass of
arts and health activity. If there had been more time we would have
considered adding a focus group in the Birmingham area.
Participants were informed that the focus for the discussions would be
practice, research and training for Music & Health, with a particular emphasis
on:
• the strategic development of the sector

• the development and provision of relevant training
• professional standards
• commissioning
• capacity building for the sector,
• aspects of evidence based methods
• evaluation and research
The discussion in each group was then allowed to emerge naturally, with
facilitation from Josie and Niki to ensure that participants were all able to have
their say and that the groups stayed on topic.
We tried to balance our invitation lists so that we had representatives from as

broad as possible a range of Music & Health activity. This was particularly
successful in London, where we had input from a freelance
composer/musician; national Music & Health, community music and youth
music organisations; a conservatoire; a hospital arts organisation; a Music &
Health practitioner; and two organisations that work with mental health service
users and dementia sufferers through music.
London focus group (L-R):

Victoria Hume, Kathryn Deane
39
As there were a number of national organisations in the room in London, the

discussion there particularly centred on policy and best practice; however, the
practitioners present also provided a useful focus on the values underlying
Music & Health work. We used a meeting room in the Orchestra of the Age of
Enlightenment’s offices. Music & Health is not a central part of the Orchestra’s
activity, but as keen music educators, they were pleased to be able to host a
Music & Health discussion.
At the Bristol group, the invitation list was also well balanced between
practitioners and people in management roles and we managed to draw
participants in from South Wales and Dorset, in addition to the Bristol area
itself. Willis Newson, the host organisation, is the UK’s leading arts and health
consultancy and is particularly interested in evaluation and research. The
company recently appointed Megan Attwood as Evaluation and Research
Lead through the Knowledge Transfer Programme, in partnership with the
University of the West of England. As we also had a programme leader from a
higher education course in Creative Therapies at the table, the Bristol
discussion particularly focused on education and evaluation.
Bristol focus group (L-R):

Les Petrie, Rachel Millman and
Jane Willis
At our final group in Manchester, it proved a challenge to fill the group with
Music & Health specialists, not because the area is lacking in them – the
Music & Health centre at the Royal Northern College of Music is at the centre
of an important hub of activity – but because of clashes with meetings and
events elsewhere. Those who could attend the group came from the East and
West Midlands as well as the Greater Manchester/Lancashire area.
We were glad to have the input of two veterans of the arts and health scene,
Brian Chapman from LIME and Clive Parkinson from Manchester Metropolitan
University. Brian and Clive were able to give us the perspective of their long
experience in the field and to make parallels between the challenges faced by
musicians and visual artists working in health settings. We also welcomed
contributions in Manchester from several organisations that place musicians
into healthcare settings, and two musicians who now lead participatory music
in health initiatives.
40

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Mapping

A Nordoff Robbins Consultation

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Nordoff Robbins Research Department

Tel: +44 (0)20 7267 4496

Index of contents ............................................................................ 1

Foreword to Public Report.............................................................. 2

A Note from Josie Aston................................................................. 2

Background to the Report............................................................... 3

2. Practices in Music & Health: considering values and voices ...... 9

3. TEN MUSIC & HEALTH CASE STUDIES................................ 13

4. Training for Music & Health ........................................................ 7

5. Evaluation and research............................................................. 8

Appendix 1: Mapping of Music & Health projects ......................... 34

Appendix 2: People/organisations researched, by area ............... 36

Appendix 3: The Music & Health focus groups............................. 39

Foreword to Abridged Report

Prof Mercédès Pavlicevic, Director of Research

A Note from Josie Aston

Background to the Report

This consultation has been very different from previous consultations,

This report begins by setting the political, economic and organisational

1.2 Economics, politics and public policy

Arts and health, as described above, is a burgeoning sector. However, in

It is interesting to reflect on whether it is generally necessary to publish a 200

1.3 Changes in healthcare; impact of the recession

However, healthcare policy appears to be changing. The White Paper issued

As I write the final words of this report, the Coalition government’s

However, I believe that there are opportunities as well as threats in such a

1.4 Training for Music & Health

The emergence of specific training courses in Music & Health is a relatively

The range of skills needed and challenges faced by musicians wishing to

and social care staff is recognised as equal in importance to the training of

1.5 Evaluation and research

It must be said that the impact of arts participation on health is notoriously

However, the standard of evaluation is improving and robust research in arts

2. Practices in Music & Health: considering values and

What are our values?

“professionalise, professionalise, science, science, measure, measure,

Where are service users in all this? What do they want?

How an organisation describes its participants is often a clue to the model

It is possible that the changes occurring in healthcare could work to help

Andrew went on to explain that through some types of commissioning:

“…you get service users together to ask for a service…that group of

This prompted Kathryn MacDonald from More Music in Morecambe to tell us

While there are of course older people in challenging financial circumstances,

3. TEN MUSIC & HEALTH CASE STUDIES

Changing Tracks is a project that aims to use music to encourage young

The Hive is an independent arts organisation based in Shrewsbury that works

The Changing Tracks project began in 2006 as part of a community policing

Sven Worrow is an experienced musician who has worked extensively with

CASE STUDY 2: The Music Well Local organisation

The Music Well is a community interest company providing music

Music Well sessions, with kind permission of Liz Butt

Groups Music Well’s music leaders have facilitated have included: an

CASE STUDY 3: National organisation

A Wales-wide initiative to enable and encourage amateur music groups

Ty Cerdd, the Welsh Federation of Amateur Musicians was formed in 1969

In 2007, Keith Griffin, Director of Ty Cerdd – Music Centre Wales contacted

Following a meeting with the Minister, the Director sent a questionnaire to

It is the responsibility of the performing ensemble to negotiate the time and

In some hospital settings, an arts co-ordinator has been available to make

No formal evaluation of the project is currently undertaken by Ty Cerdd,